Cocaine Withdrawal
Brief History of Cocaine
Cocaine is a substance found in a plant (Erythoxylum coca) which is native to Peru, Bolivia, and Ecuador and is cultivated in many other countries. Natives of the countries in which the coca plant was part of the landscape chewed the leaves to increase energy, alertness, and endurance.
The leaves of the plant are ground into a paste and heated with hydrochloric acid producing cocaine in its powder form. In its powder form, cocaine is most often separated into “lines” and snorted.
Modern cocaine was originally synthesized in 1855 and by 1880 the medicinal qualities of cocaine were first recognized by the medical community. Although it was widely credited as a cure for many ailments, cocaine was primarily used as a surgical anesthetic.
Cocaine was introduced to many Americans as an ingredient, combined with African kola, in the popular soft drink Coca-Cola in 1886. During this era, cocaine was strongly endorsed by the medical community and could be found in many over the counter tonics and elixirs.
The largely unregulated use of cocaine led to an unforeseen epidemic of cocaine addiction in America. Estimates from 1902 claim 200,000 had become addicted to cocaine and by 1907 U.S. coca leaf imports had increased three-fold since the turn of the century.
The Harrison Narcotic Act of 1914 outlawed the use of cocaine in the U.S. and its popularity decreased until the 1970s, as many again doubted its addictiveness. Cocaine continued to be seen as a relatively harmless recreational drug until the mid-1980s and the arrival of crack cocaine (A Social History).
Crack Cocaine
Withdrawal from Cocaine
Crack, a solid form of cocaine which is typically smoked, emerged as a stronger, cheaper alternative for powder cocaine in the mid-1980s. Crack provides an immediate, short, intense high and is extremely addictive. The crack epidemic is tied to an increase of addiction, a rise in crime rates, and instances of severe physiological damage in babies born to crack users. Punishment relating to crimes associated with crack versus punishment associated with powder cocaine is a constant source of debate and controversy in the U.S. (qtd fm, Fryer R, Heaton P, et al.)
Cocaine Dependence
According to the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Dependence upon cocaine is evident if three of the following criteria are met:
- Developing tolerance to the euphoric effects of cocaine and requiring more drug to produce the desired effects.
- Stopping cocaine usually results in withdrawal symptoms (such as fatigue, sleep disturbances, agitation, or depression), and these symptoms can be relieved by using cocaine again.
- Using cocaine in large amounts whenever it is available. (Seldom do people save some for later.)
- Inability to successfully reduce the amount of cocaine one is using.
- Spending a great deal of time and energy obtaining and using cocaine, which isolates one from friends and family, and/or engaging in unlawful activities such as shoplifting, theft, burglary, or homicide to obtain money to buy cocaine.
- Inability to successfully maintain employment while using cocaine because of ineffectiveness at work, increased absenteeism, inability to hold a job, or inability to find work.
- Continually using cocaine despite knowing one will develop mental symptoms, such as paranoia, hallucinations, and delusions, and/or continually using cocaine despite medical consequences, such as weight loss, anemia, or seizures (qtd fm, Morton W).
Due to the intense “rewards” provided by cocaine, attempts at recovery from cocaine addiction can be extremely challenging. Among the challenges, upon cessation of use, are the withdrawal symptoms.
Cocaine Withdrawal
Typically, an extended cocaine binge is followed by a devastating crash and an intense craving for more cocaine. Because the physical withdrawal symptoms associated with cocaine addiction differ from the of heroin or alcohol (vomiting, shaking, etc…), the severity of cocaine addiction is often underestimated. More a psychological addiction, cocaine dependence clearly qualifies as an addiction when defined as: “a desire for more of the drug, despite negative consequences” (Cocaine Withdrawal).
Cocaine withdrawal symptoms include:
- Agitation and restless behavior
- Depressed mood
- Fatigue
- Generalized malaise
- Increased appetite
- Vivid and unpleasant dreams
- Slowing of activity (Cocaine Withdrawal)
Despite the fact that continued cocaine use becomes less and less pleasant for the addict (increased paranoia, depression, and fear; rather than euphoria), craving for more cocaine remains intense. Following cessation, these psychological cravings can last for months. Suicidal thoughts are often experienced during the withdrawal process.
Intense craving, depression, general malaise, and agitation typical of cocaine withdrawal are considered as powerful as similar withdrawal symptoms associated with alcohol and heroin withdrawal. The debilitating effects of these symptoms are often what lead the individual back to using cocaine.
While the physical symptoms associated with cocaine withdrawal may be milder than those of alcohol or heroin abuse, withdrawal from any long-term substance use should be taken very serious. Although cocaine withdrawal symptoms generally ease and go away with time, often the cocaine abuser will begin using and abusing other substances such as alcohol and benzodiazepines to ease the discomfort. The risk of suicide and/or overdose is ever-present with this type of withdrawal strategy.
Cocaine addiction is often paired with coexisting psychiatric disorders such as depression and bi-polar disorder. Whether these conditions are preexisting or cocaine induced; treatment of these disorders has proven to be highly necessary in the recovery of the cocaine addict. While no drug has been found to be effective in curbing the intense cravings of withdrawal, pharmacologic treatment of coexisting psychiatric disorders has proven to be highly effective (Morton, W).
Conclusion
Cocaine, largely considered a relatively harmless recreational drug until the mid-1980s and the emergence of crack; has proven to be anything but harmless. Crack cocaine has been proven to be a correlate with crime, violence, poverty, broken homes, birth defects, etc… Despite the absence of physical withdrawal symptoms, the psychological pull of cocaine makes recovery from cocaine addiction a difficult, but possible, challenge. According to experts in the field of recovery, the only sure way to avoid becoming addicted to cocaine is to stay away from cocaine entirely.
References
“A Social History of America’s Most Popular Drugs”. Frontline. WGBH Educational Foundation 2013. Web. Retrieved from: http://www.pbs.org/wgbh/pages/frontline/shows/drugs/buyers/socialhistory.html
Fryer, R., Heaton, P., et al. “Measuring Crack Cocaine and its Impact”. National Bureau of Economic Research. Fryer, Heaton, Levitt, Murphy 2005. Retrieved from: http://www.nber.org/papers/w11318.pdf?new_window=1
“Cocaine Withdrawal”. MedlinePlus. A.D.A.M., Inc. 2011. Web. Retrieved from: http://www.nlm.nih.gov/medlineplus/ency/article/000947.htm
Morton, W. “Cocaine and Psychiatric Symptoms”. NCBI. Physicians Postgraduate Press, Inc. 1999 Aug; 1(4): 109–113. Web. Retrieved from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC181074/